I lost most of yesterday going with my 92 year old mother to the ER at Grandview Medical Center. As you’ll see shortly, this misadventure shed light on some coronavirus issues. If medical professionals aren’t being vigilant about coronavirus risks in one of the few places in Alabama that had some sensible post-lockdown provisions that unfortunately weren’t in place all that long (mandatory masks in public), God forbid where the state and other red states will be in a month.
My mother fell two nights ago. In her carpeted bedroom, she bent down to pick up something off the floor using her little walker for support, even though I have repeatedly told her never to pick up anything from the floor, to leave it or call me. The walker fell over and she fell partly on it.
She seemed more bruised than anything but was also very badly shaken up, particularly since it took some doing for me to hoist her off the floor. She was quite banged up on one shin, and on one side from her mid waist to hip. My hypothesis was that she’d badly bruised her floating rib and the general area.
She had pain only when lying on that side and when going from lying down to sitting or vice versa. The next day, once she finally got out of bed (she’d slept very badly due to difficulty of finding a good position; she normally sleeps on her damaged side.
We had a home duty nurse come in to give her a look, which happened a day later than it should have, meaning yesterday. The nurse did a pretty thorough exam, thought she was OK, no sign of internal damage, not too much soreness where she poked.
By happenstance, the aide and I sat Mom up in bed so she could stand before the nurse left. The nurse didn’t like how painful that was. The nurse though she might have a hip fracture or a fractured floating rib and wanted her checked out. I was resistant due to coronavirus risk.
The nurse and one of the managers at the agency (also a nurse) recommended Grandview Medical Center as being the least exposed hospital. So off to the ER.
We had a series of not good incidents on the coronavirus front on the way to my mother getting diagnosed.
I rode in the ambulance in the front seat. Driver was not wearing a mask.
At the ER, there was a tent next to the entrance with clear plastic sheeting on its front side. I asked if that was for coronavirus testing. No, I was told it was for coronavirus screening before entering. I would assume that would normally consist of at least taking temperatures. But no one was there and the EMTs seemed a little puzzled that we breezed in.
I’m used to ERs where patients are registered immediately and screened for triaging purposes. Then you sit around and wait. Here, even though my mother was strapped into a gurney, the two EMTs rolled her about 3 feet from a long counter that had work spots behind and below it, with more workspaces behind. Not all the spots were filled but about a half dozen were, and all but one was wearing medical scrubs and masks (the woman dressed in non-hospital garb was also masked).
No one else was in intake limbo. Normally, I would have acted like a New Yorker and found out what was up and what the process was, but the ambulance guys acted as if this was normal. They’d also told me I wasn’t supposed to be there and I would be shooed to the lobby, but that never happened (I’ve never heard of an ER not allowing an immediate relative to participate in intake and seeing the doctor).
While I was parked on a chair, waiting, someone in scrubs came though the lobby, sweeping up odds and ends. His mask was pulled down well below his nose.
After we got done with the imaging (results seemed to be the least bad of possible bad outcomes1) we had more fracas getting me back home than anticipated. The nurses earlier in the day had recommended that a ambulance take her back, if nothing else to have a couple of strong guys wheel back to her bed and put her in it. They’d assumed I could ride back.
No dice. Five ambulance companies refused, including the one that had given me the ride out. So I had to call and wait a LONG time for a cab, well after the ambulance had left.
So your humble blogger was back in the ER intake open area where I was not supposed to be, in a chair off to the side by the entrance doors so as to be out of the way.
Someone wheeled in a gurney with a very old woman in it, pallid and with her eyes closed. The EMT, who was standing next to her, was not wearing a mask, and she wasn’t either. Both were less than six feet from me.
I cleared my throat and said by putting her so close to me, he was endangering her. This was the only way I thought to get the idea of “endangering her” in without calling him out directly for not wearing a mask.
Maskless EMT instead told me to move. I informed him I am injured (true) and there was nowhere else to sit. He refused to shift the gurney even though there was plenty of room for him to scoot it a couple of feet.
So, screwing my joints up in the process, I hauled the two heavy and one heavy-ish bags I’d brought (laptop, charger, book, stuff my mother would need if she was admitted), the chair, and me through the inner set of sliding glass doors and sat in the little vestibule between them and the outer glass doors.
You’d think moving furniture to a place it was ostentatiously not supposed to be, in full view of the hospital staff walking through the intake area and even some in the seats, might get some notice of the “You aren’t supposed to be there” sort, allowing me to complain about the latest incident of maskless medical staffers in their facility, and ask why weren’t they doing something about it.
Instead, after a while, a nurse came to tell me my cab was coming and helped me get to the main lobby.
This casualness about mask discipline in a hospital is jarring. I can’t tell how much of this behavior is about this hospital versus the South generally. I did tell this story to a colleague who knows a California teaching hospital well, and he was shocked.
Birmingham is already getting overflow coronavirus cases from Montgomery, which is just about out of ICU beds. So it looks like a hot and sickly summer is around the corner.
1A CAT scan showed acute fracture in her third lumbar vertebra.
Weirdly that is less bad than any other problem they could have found. A hip fracture would would mean an operation even if all they did was put a pin in her. I’m leery of general anesthesia for old people. It appears in some cases to worsen cognitive decline.
There is not much to do except for her to wear a back brace and take pain meds. I was pushy so she got both before she left.